Joseph Devan Wilson OD

NPI 1669755591 - Optometrist - 152W00000X

NPI Details
NPI 1669755591
Gender Male
Enumeration Date 09/27/2011
Last Updated 07/14/2014
Entity Type Individual
Active Over 5 years ago
Practice Location
2229 S MEMORIAL PL
SHEBOYGAN WI, 53081-3715, US
Phone (920) 458-9301
Fax
Business Location
1012 FALLS PARC DR
APARTMENT 15
SHEBOYGAN FALLS WI, 53085-3370, US
Phone (360) 317-6495
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Wisconsin
License Number 3352 - 35
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According to our database, Dr. Joseph Devan Wilson OD NPI is 1669755591, taxonomy code is 152W00000X and license number is 3352 - 35, license state is located at Wisconsin. Joseph Devan Wilson OD physically located at 2229 S Memorial Pl, Sheboygan WI, 53081-3715. NPI Number Joseph Devan Wilson OD has the Individual type.

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1669755591 NPI number is provided on an as is basis without warranty of any kind. 1669755591 is maintained by the National Plan & Provider Enumeration System. The contents of Joseph Devan Wilson OD are for informational purposes only.